Connect Chagos Internship Application Form

Connect Chagos Internship Application Form

Please carefully complete each section of the form and either:

·  Email to (in the subject line of the email please clearly state what position you are applying for).

·  Post to the address at the end of the application.

·  Or hand directly to a member of the Connect Chagos team.

The deadline for receiving applications is Friday 6th February.

PERSONAL DETAILS

Surname: First Names: Title:
Other surnames you have been known by:
Address:
Post code:
Home (: Work (:
Mobile (: Email address:
Do you require a work permit to work in the UK? Yes [ ] No [ ]
If yes, what type of Home Office UK Border Agency visa do you currently hold:
Visa expiry date:
National Insurance No:

PRESENT OR MOST RECENT EMPLOYMENT

Employer:
Address:
(:
From: To: Salary: £
Job Title: Grade if applicable:
Main Responsibilities:
Notice Period: Reason for Leaving:

EMPLOYMENT HISTORY

Please give details of all previous employment/voluntary positions starting with the most recent (including periods of unemployment). If you are still in full time education, please give details of any vacation or part time employment. The information given may be used to obtain references at a later date.

Employer / Employed from
__ / __ / __ / Employed to
__ / __ / __ / Position held, duties and reasons for leaving
Full Name and Address
(:
Full Name and Address
(:
Full Name and Address
(:
Full Name and Address
(:
Full Name and Address
(:

Please continue on a separate sheet using the same format if necessary

EDUCATION AND QUALIFICATIONS

Starting with the most recent:

Secondary/Further Education/Relevant Qualifications or Courses Completed

School / College or University / Subject or Course / Examination e.g. GCSE (if applicable) / Grade (if applicable)

SUPPORTING STATEMENT

In this section you must give full details of how your skills, abilities and experience match the details provided in the job description. Please continue on a separate sheet if necessary.

(Please note that CV’s will not be accepted as a supporting statement)

DISCLOSURE OF CRIMINAL RECORD

All candidates for posts which give them access to children or young people are required under the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975, if offered an appointment, to disclose details of all previous convictions. Disclosure of any criminal conviction(s) will not necessarily debar you from employment with the Society - this would depend on the nature of the offence(s) and their relevance to this appointment.

Failure to declare previous convictions may prevent your employment if it subsequently becomes apparent that you do, in fact, have a criminal record. Some employment offered by the Society will be subject to completion of a DBS and a receipt by the Society of a satisfactory Disclosure certificate.

Please answer the following questions:

“Do you have any unspent convictions, cautions, reprimands or warnings?”

Yes No

ASSOCIATION WITH ZSL

Have you been employed (either in a paid or unpaid capacity) by the Zoological Society of London before?

If yes, please give details (dates, role etc.): ______

______

Are you related to an employee, volunteer, Fellow or Trustee of the Society?

If yes, please give details: ______

HOW DID YOU HEAR ABOUT US?

To help us monitor our advertising, please state where you first saw this post advertised:

PLEASE READ THE FOLLOWING DECLARATION CAREFULLY BEFORE SIGNING THIS FORM

I declare that the information given in this application is to the best of my knowledge complete and correct. I understand that the Society reserves the right to seek verification of any information provided. I understand that if it is discovered that I have given false information I may be dismissed from the Society’s employment. I suffer no legal impediment to taking up appointment.

The Society complies with the Data Protection Act 1998.

I agree to the Society using the information contained in this form for the proper administration of the recruitment process and should I be successful I agree that the information will be used as part of the employment relationship.

Signature...... Date...... …......

Name (Print)...... …………….………………………………......

If you wish to post your application please address it clearly to:

Connect Chagos Project

Discovery & Learning

London Zoo

Regent’s Park

London

NW1 4RY

For further information and assistance with completing the application you are welcome to contact the Connect Chagos Team using the details below. Alternatively an opportunity to meet the team in person will be provided in Crawley and Manchester before the application deadline.

Rudy Pothin / Amdeep Sanghera / Kirsty Richards
Connect Chagos Outreach Assistant / Connect Chagos Support Officer / Connect Chagos Project Coordinator
/ /
Phone: 020 7449 6646 / Phone: 020 7449 6646 / Phone: 020 7449 6480